Abstract
Objective
To investigate whether the severity of preeclampsia and a history of recurrent episodes of preeclampsia increase the risk for long term maternal cardiovascular disease (CVD).
Study Design
A population-based study compared the incidence of long-term CVD in a cohort of women with and without a history of preeclampsia. Deliveries occurred between the years 1988-2012, with a mean follow-up duration of 11.2 years. Preeclampsia was divided according to severity.
Kaplan-Meier survival curves were used to estimate cumulative incidence of CVD hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for CVD.
Results
During the study period 96,370 parturient met the inclusion criteria; 7824 (8.1%) occurred in women who were diagnosed at least once with preeclampsia. Using a Kaplan-Meier survival curve, patients with a history of preeclampsia had a significantly higher cumulative incidence of cardiovascular hospitalizations (Figure). A significant linear association (using the chi-square test for trends) was noted between the severities of preeclampsia to simple as well as complex CVD and total cardiovascular hospitalizations (Table). Likewise, a linear association was found between the number of previous pregnancies with preeclampsia (no preeclampsia, one event and two or more events) and future risk for simple CVD (1.2% vs. 1.6% vs. 2.2%, respectively; P= 0,001), complex CVD (1.3% vs. 2.7% vs. 4.6% respectively; P= 0,001) and total cardiovascular hospitalizations (2.7% vs. 4.4% vs. 6.0% respectively; P= 0,001). In a Cox model, adjusted for confounders such as maternal age, parity, diabetes mellitus, and obesity, a history of preeclampsia remained independently associated with cardiovascular hospitalizations (adjusted HR, 1.7; 95% CI, 1.6-1.9; P=0.001).
Conclusion
Previous pregnancy with preeclampsia is an independent risk factor for long-term maternal CVD. The risk is more substantial for patients with severe and recurrent preeclampsia.
To investigate whether the severity of preeclampsia and a history of recurrent episodes of preeclampsia increase the risk for long term maternal cardiovascular disease (CVD).
Study Design
A population-based study compared the incidence of long-term CVD in a cohort of women with and without a history of preeclampsia. Deliveries occurred between the years 1988-2012, with a mean follow-up duration of 11.2 years. Preeclampsia was divided according to severity.
Kaplan-Meier survival curves were used to estimate cumulative incidence of CVD hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for CVD.
Results
During the study period 96,370 parturient met the inclusion criteria; 7824 (8.1%) occurred in women who were diagnosed at least once with preeclampsia. Using a Kaplan-Meier survival curve, patients with a history of preeclampsia had a significantly higher cumulative incidence of cardiovascular hospitalizations (Figure). A significant linear association (using the chi-square test for trends) was noted between the severities of preeclampsia to simple as well as complex CVD and total cardiovascular hospitalizations (Table). Likewise, a linear association was found between the number of previous pregnancies with preeclampsia (no preeclampsia, one event and two or more events) and future risk for simple CVD (1.2% vs. 1.6% vs. 2.2%, respectively; P= 0,001), complex CVD (1.3% vs. 2.7% vs. 4.6% respectively; P= 0,001) and total cardiovascular hospitalizations (2.7% vs. 4.4% vs. 6.0% respectively; P= 0,001). In a Cox model, adjusted for confounders such as maternal age, parity, diabetes mellitus, and obesity, a history of preeclampsia remained independently associated with cardiovascular hospitalizations (adjusted HR, 1.7; 95% CI, 1.6-1.9; P=0.001).
Conclusion
Previous pregnancy with preeclampsia is an independent risk factor for long-term maternal CVD. The risk is more substantial for patients with severe and recurrent preeclampsia.
| Original language | English |
|---|---|
| Pages (from-to) | S162-S163 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| Issue number | 1 |
| DOIs | |
| State | Published - 31 Jan 2014 |
